充血性心力衰竭患者脑利钠肽与左室质量指数相关性研究（修改后）.doc免费

慢性心力衰竭患者脑利钠肽水平与 左室质量指数相关性研究 河北医科大学第三医院心内科 李海滨 摘要 目的：本文旨在研究脑利钠肽（brain natriuretic peptide, BNP）对慢性心力衰竭（chronic heare failure, CHF）的诊断价值和CHF患者血浆BNP水平与左室质量指数的相关性。 方法：选择65例CHF患者（心功能Ⅲ～Ⅳ级）及48例正常对照组。采用酶联免疫吸附法测定两组血浆BNP水平；超声心动图测定左室质量指数。并将CHF患者的BNP水平与左室质量指数作相关性分析。 结果：CHF患者的BNP水平与左室质量指数显著高于正常对照组〔（562.4±182.1）pg/mL比﹙84.2±9.6〕pg/mL(P0.001)和（168.26±58.33）g/m2比（112.18±14.50）g/m2(P0.001)〕；BNP水平与左室质量指数呈显著正相关（r=0.387;P0.01），取正常对照组BNP浓度的χ+1.96s为正常上限值，BNP诊断CHF的敏感性为92%，特异性为93%。在CHF组，血浆BNP浓度在不同心功能分级之间也有显著差异（P0.01）。 结论：血浆BNP水平对于诊断CHF具有较高的敏感性和特异性，并且与LVMI密切相关。 关键词 心力衰竭 利钠肽，脑 The Relationship Between the Level of Brain Natriuretic Peptide and Left Ventricular Mass Index in Patients with Chronic Heart Failure LI Haibin, Cao Haiyu, LIU Kunshen Department of Cardiology, First Affiliated Hospital, Hebei Medical University, Shijiazhuang （050031）,Hebei Abstract Obective：To estimate the diagnostic value of the level of plasma brain natriuretic peptide (BNP) in patients with chronic heare failure (CHF) and the relationship between the level of BNP and left ventricular mass index. Methods：65 cases of CHF and 48 healthy cases were selectd into the study.The plasma concentrations of BNP were measured by enzyme-linked immunosorbent assay.Left ventricular mass index was measured by two-dimentional echocardiography. Results：The plasma concentrations of BNP and left ventricular mass index were much higher in CHF patients than those in healthy subjects 〔（562.4±282.1）pmol/L vs ﹙184.2±98.6〕pmol/L(P0.001)and（168.26±58.33）g/m2 vs （112.18±14.50）g/m2(P0.001)〕.The correlations between the level of BNP and left ventricular mass index in CHF patients （r=0.387;P0.01）.The sensitivity of 92%,specificity of 93% for BNP in diagnosis of CHF were evaluated according to the of BNP in henlty subjects as the normal high limit.There were significant differences of BNP level among NYHAⅢ～Ⅳ in CHF patients（P0.05）. Conclusion：Plasma BNP level may be the more valuable for diagnosis